Urinary Incontinence, Depression, and Economic Outcomes in a Cohort of Women Between the Ages of 54 and 65 Years

Abstract

Objective To estimate the association between urinary incontinence and probable depression, work disability, and workforce exit. Methods The analytic sample consisted of 4,511 women enrolled in the population-based Health and Retirement Study cohort. The analysis baseline was 1996, the year that questions about urinary incontinence were added to the survey instrument, and at which time study participants were 54–65 years of age. Women were followed with biennial interviews until 2010–2011. Outcomes of interest were onset of probable depression, work disability, and workforce exit. Urinary incontinence was specified in different ways based on questions about experience and frequency of urine loss. We fit Cox proportional hazards regression models to the data, adjusting the estimates for baseline socio-demographic and health status variables previously found to confound the association between urinary incontinence and the outcomes of interest. Results At baseline, 727 participants (survey-weighted prevalence, 16.6 percent; 95% confidence interval [CI], 15.4–18.0) reported any urinary incontinence, of which 212 (survey-weighted prevalence, 29.2 percent; 95% CI, 25.4–33.3) reported urine loss on more than 15 days in the past month; and 1,052 participants were categorized as having probable depression (survey-weighted prevalence, 21.6 percent; 95% CI, 19.8–23.6). Urinary incontinence was associated with increased risks for probable depression (adjusted hazard ratio [AHR], 1.43; 95% CI, 1.27–1.62) and work disability (AHR, 1.21; 95% CI, 1.01–1.45) but not workforce exit (AHR, 1.06; 95% CI, 0.93–1.21). Conclusions In a population-based cohort of women between the ages of 54 and 65, urinary incontinence was associated with increased risks for probable depression and work disability. Improved diagnosis and management of urinary incontinence may yield significant economic and psychosocial benefits.

Urinary incontinence, work, and intention to leave current job: A cross sectional survey of the Australian nursing and midwifery workforce

“…Some working women have indicated that UI affected decisions about employment by a reduction of the number of hours worked or change in the type of work undertaken . UI in older women has been predictive of work disability (measured by self‐report of work limitations), but not workforce exit . Thus, findings of the current investigation have significant implications for the workforce.…”

A systematic review of prevalence and impact of symptoms of pelvic floor dysfunction in identified workforce groups

“…This is important because several population‐based studies have shown a relationship between mental health and LUTS (Hung et al . , Lung‐Cheng Huang et al . ), although further studies are required to establish any causal links and investigate pathophysiological mechanisms.…”

“…Further, UI increased an individual's risk of work disability in a US follow‐up study of 4511 of women aged between 54–l65 years enrolled in the ‘Health and Retirement Cohort’ (Hung et al . ). These findings indicate the potential impact of PF dysfunction in a workforce.…”

Depression and the incidence of urinary incontinence symptoms among young women: Results from a prospective cohort study

“…Studies have established that depression and UI are often comorbid [10][11][12][13][14][15][16], but the role of depression as a cause or consequence of UI is less clear. Furthermore, previous studies have primarily focussed on mid-age and older women, with the result that much less is known of the aetiology of UI and links between depression and the condition among younger women [5].…”